Insurance Verification Specialist

60100 BDx Solutions, Inc. USA; Houston (TX); On-site; USD 60,000 - 90,000; Full time

Job summary

Baxter in Houston, TX is seeking a detail-oriented Reimbursement Specialist to optimize patient account reintegration into the reimbursement cycle. You will customize authorization workflows, verify coverage, and coordinate with payers to accelerate claim adjudication.

Join a team dedicated to improving access to care and ensuring accurate demographics and benefits data, ultimately reducing claim delays and supporting patients through complex billing processes.

Responsibilities

• Develop a flawless strategy to reintegrate patient accounts into the reimbursement process, either through acquiring prior authorization, performing change of insurance, or securing payment on claims.
• Perform detailed research on patient accounts within our "Error processing" process to identify gaps hindering reimbursement and offer a comprehensive summary for resolution.
• Apply outstanding investigational tools to find patient contact information, including classified and confidential databases.
• Ensure the accuracy of patient demographics and benefit information on file to minimize claim submission errors.
• Process claims promptly, identifying and resolving issues causing delayed processing and adjudication.
• Identify payer trends and implement payer-specific strategies to overcome reimbursement challenges.
• Review revenue reports like "claim validation" and "return billing report" to ensure reimbursement procedures are followed.
• Contact patients, families, and caregivers as needed to acquire current demographics, insurance, physician, and device usage information to ensure appropriate insurance reimbursement.
• Ensure timely follow-up and completion of errors received and authorizations initiated.

Job description

Who We Are

This is where your work makes a difference. At Baxter, we believe every person—regardless of who they are or where they are from—deserves a chance to live a healthy life. It was our founding belief in 1931 and continues to be our guiding principle. We are redefining healthcare delivery to make a greater impact today, tomorrow, and beyond. Our Baxter colleagues are united by our Mission to Save and Sustain Lives. Together, our community is driven by a culture of courage, trust, and collaboration. Every individual is empowered to take ownership and make a meaningful impact. We strive for efficient and effective operations, and we hold each other accountable for delivering exceptional results. Here, you will find more than just a job—you will find purpose and pride.

Who We are At Baxter, we are deeply connected by our mission. No matter your role at Baxter, your work makes a positive impact on people around the world. You'll feel a sense of purpose throughout the organization, as we know our work improves outcomes for millions of patients. Baxter's products and therapies are found in almost every hospital worldwide, in clinics and in the home. For over 90 years, we have pioneered significant medical innovations that transform healthcare. Together, we create a place where we are happy, successful and inspire each other. This is where you can do your best work. Join us at the intersection of saving and sustaining lives - where your purpose accelerates our mission.

What You'll Be Doing

• Develop a flawless strategy to reintegrate patient accounts into the reimbursement process, either through acquiring prior authorization, performing change of insurance, or securing payment on claims.
• Perform detailed research on patient accounts within our "Error processing" process to identify gaps hindering reimbursement and offer a comprehensive summary for resolution.
• Apply outstanding investigational tools to find patient contact information, including classified and confidential databases.
• Ensure the accuracy of patient demographics and benefit information on file to minimize claim submission errors.
• Process claims promptly, identifying and resolving issues causing delayed processing and adjudication.
• Identify payer trends and implement payer-specific strategies to overcome reimbursement challenges.
• Review revenue reports like "claim validation" and "return billing report" to ensure reimbursement procedures are followed.
• Contact patients, families, and caregivers as needed to acquire current demographics, insurance, physician, and device usage information to ensure appropriate insurance reimbursement.
• Ensure timely follow-up and completion of errors received and authorizations initiated.